Thursday, November 16, 2006

All American Senior Care: Immigrants, increasingly, provide elder care in U.S.

Not only are immigrants a major source of employees right now this trend is expected to grow very fast in the future.

Immigrants, increasingly, provide elder care in U.S.

Scripps News

Thursday, November 16, 2006

Wanda Moeller's blue eyes dance when she talks about Franklin D. Roosevelt, the Grand Ole Opry _ and Haydee Carrillo, the Salvadoran immigrant who has helped care for her for six years.

Three mornings a week, Carrillo lifts the partially paralyzed Moeller from bed and gives her a bath, breakfast and oxygen treatment. Then she applies lipstick for her 76-year-old client, and the two run errands or have fun talking or looking at photos of grandchildren.

"She's like a daughter to me," the Oklahoma-born Moeller said, as Carrillo, 60, smiled and wiped a drop of cafe latte from Moeller's chin.

In the same Sacramento, Calif., apartment building, another elderly client also praises Carrillo. "Her mother was killed in El Salvador's war," said Merle Heath, 78, as Carrillo hooked up his oxygen to treat severe bronchitis. "Her English isn't too good. But she's a loyal, good Christian."

As Heath has learned, Carrillo's life began a world apart from the universe she now shares with the American septuagenarians she cares for, at $10 an hour. That they have all crossed paths in the United States, however, is no longer a rare phenomenon.

Immigrants are rapidly taking on prominent roles as American families' caregivers, whether those immigrants are naturalized citizens, permanent residents, undocumented or _ like Carrillo _ in between. They nurture babies, keep house and, increasingly, care for America's surging population of senior citizens.

Immigrants make up nearly 18 percent of the nation's baby sitters and in-home aides for seniors or people with disabilities, according to the Migration Policy Institute, a nonpartisan research center.

At the same time, many involved in senior care are discovering that the U.S. immigration system offers few avenues for recruiting and legally employing caregivers to help meet exploding demand. A job like Carrillo's, that of home health aide, is expected to be the fastest-growing job in America for the next decade.

"Even if you substantially raise salaries, and I'm not sure you can, it's not clear there is enough of a latent native work force," said Michael Fix, the Migration Policy Institute's vice president. "You shouldn't idealize immigration as a solution," he said, but added that it could be helpful "to take this flow and make it a regulated flow."

Undocumented workers, senior advocates say, are filling many of these jobs, in private homes and even in facilities _ such as nursing homes _ where employers are required only to see, not authenticate, a green card.

Families, too, are dismayed to find out that if they try to do "the right thing," as one daughter of a 95-year-old said, and legalize a trusted caregiver, the process is next to impossible. Only 5,000 low-skilled immigrant work visas can be issued annually and waiting times are now up to more than five years.

Escalating demand for senior care is shared by Italy, Austria and other aging nations that already rely on caregivers from poorer countries, according to a 2005 report by AARP, an advocacy organization for older Americans.

That report urges an expansion of U.S. programs to train more American elder-care workers of all levels, but acknowledges that the supply of homegrown applicants for such programs is finite.

AARP's report notes: "Meeting the long-term care needs of the growing older populations in more developed nations requires more engagement across international boundaries."

Heath, who is virtually bedridden, said his own experience shows how much workers like Carrillo are already vital. "We should be helping people like her," he said. "Not a lot of able-bodied American men out on the street want to do this."

Carrillo cites her religious faith and difficult life _ her mother's murder, prolonged separation from her children _ as factors that have strengthened her empathy for "ancianos," as seniors are called in Spanish.

Caregivers like her must be strong and skilled enough to lift immobile adults and help them into wheelchairs, and patient enough to provide companionship and intimate needs, like washing, clipping nails and, for the most frail, changing diapers.

"You can't mechanize taking care of the elderly," said Ken Preede, director of government relations for the American Health Care Association, which has joined other industries in lobbying for an earned legalization of undocumented workers.

Health and Moeller live alone, in assisted-living apartments, while their children live too far away to shoulder the type of care Carrillo provides through California's In-Home Supportive Services program for seniors.

"I trust Haydee with my life," said Heath, who values his independence but is too weak to handle even simple personal tasks.

Carrillo entered the United States in 1983 _ illegally, like many who fled El Salvador's civil war. She worked cleaning houses and taking care of seniors in facilities and homes.

Her 1987 petition for political asylum eventually earned her a work permit, but her asylum was never fully approved. The U.S. government supported the Salvadoran government during the civil war, and many who fled that war were turned down for refugee status.

These days, Carrillo hangs her hopes on being granted legal permanent residency through the 1997 Nicaraguan and Central American Adjustment Act, which was designed to allow law-abiding refugees to finally integrate into the country after years of living in limbo.

"God willing, it will happen," she said in Spanish.

(The Sacramento Bee's Susan Ferriss can be reached at sferriss(at)

All American Senior Care

The CareGiver

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